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Radiation oncology uses radiation to treat cancer. The two
main ways to accomplish this in breast cancer are traditional external beam
radiation and internal radiation. With external beam radiation, a machine
delivers a rapid pulse of ionizing radiation to the entire breast from outside
the body. With internal radiation, or breast cancer brachytherapy (the prefix
‘brachy’ means slow), your doctor temporarily places a continuously emitting radioactive
material inside the breast at the site of the tumor.
High-dose rate (HDR) brachytherapy for breast cancer
delivers a very large dose of radiation. It does this without affecting as much
healthy breast tissue as external beam radiation.
When Doctors Use Brachytherapy for Breast Cancer
Doctors most commonly use HDR brachytherapy after
breast-conserving surgery for breast cancer. Lumpectomy is another name for the
surgery. This type of surgery only removes the cancer and some surrounding
healthy breast tissue.
Researchers are currently studying who will benefit most
from HDR brachytherapy for breast cancer. In general, the best candidates are
women with small, early breast cancers. It’s also desirable to have no lymph
node involvement and clear margins—when the rim of tissue the surgeon removes
has no sign of cancer cells in it.
How Brachytherapy Works
The most common form of breast brachytherapy is
intracavitary. First, the doctor inserts a catheter with a small balloon on the
end into the breast. The balloon fits into the space left after removing the
tumor. Sterile water expands the balloon to keep it in position and it remains
in place throughout the treatment.
The second step is inserting radioactive pellets through the
catheter into the balloon. The pellets deliver a set amount of radiation for a set
amount of time. Your doctor will base the dose and time on the size and
location of the tumor. Once the session is over, the doctor removes the pellets
through the catheter.
HDR brachytherapy treatments are outpatient visits. You go
for treatment twice a day, typically six hours apart, for five days. At the end
of the five-day course, the doctor will remove the balloon and the catheter.
Brachytherapy Advantages
Breast brachytherapy after lumpectomy:
-
Delivers highly concentrated radiation to the
tissues that surrounded the tumor, a place where new tumors are likely to
develop -
Limits radiation exposure to healthy breast
tissue since the whole breast does not receive radiation -
Shortens treatment time from five to six weeks
to five days
Doctors may also recommend combining HDR brachytherapy with
traditional external beam radiation therapy as a radiation boost for breast
cancer at the tumor site.
Brachytherapy Risks and Complications
Side effects of HDR brachytherapy for breast cancer are
similar to those of traditional radiation therapy for breast cancer. However,
the effects may be less severe because HDR brachytherapy spares more normal,
healthy tissue. Brachytherapy breast cancer side effects are usually temporary
and include:
-
Breast tenderness or swelling
-
Bruising
-
Mild redness
-
Reddish-pink drainage from the catheter site
It is possible to develop an infection at the catheter site.
Call your doctor right away for signs of infection, such as more redness or
pain than usual, more drainage than usual, or drainage of pus or foul-smelling
fluid.
What to Expect With HDR Brachytherapy
While the catheter is in place, you may notice your breast
feels heavy. This is normal due to the fluid that inflates the balloon. Your
doctor will give you a surgical bra to wear during this time. It will help
support your breast and protect the catheter. You will need to wear it at all
times, even when you’re sleeping.
In general, you can go about your normal activities.
However, you will not be able to shower with the catheter in place. Instead,
you can take sponge baths and wash your hair in the sink. Just avoid getting
your breast wet. You will also need to avoid lifting or carrying anything with
the arm on the same side as the treated breast. Your doctor will give you
instructions for caring for the catheter.
After your final treatment, your doctor will remove the
catheter and balloon. This procedure can be uncomfortable, so follow your
doctor’s instructions for pain management. Your doctor will have additional
instructions for caring for the site after removal.